Consulting to the public sector provides special challenges. Demographic and economic factors combine to produce important changes in social infrastructure. The major components of this infrastructure - health care institutions, social service programs, and schools, colleges and universities - have become established means of investing in the future. This investment, however, has significant operating cost implications. Health, social services and education consume the major portion of public expenditures in Canada and similar levels in other developed countries. Understanding these three program areas and developing necessary and appropriate policies, planning systems and capital development plans present an enormous challenge to those responsible for funding, managing and providing services. / FDA approved oral medication generico online for the treatment of erectile

RMC and its members are experienced in working with government and with such public sector enterprises as hospitals, social service centres, colleges and universities. This public sector work is counterpoint to our private sector consulting for large and small industrial clients. In this way we are able to evolve concepts that are transferable between the private and public sectors. However, while many planning and management techniques are transferable, they must be carefully evaluated in the context of the special sensitivities that exist for governments, institutional governing boards, program advisory committees and the wide range of professionals who both serve the public and administer programs in health, social services and education.

The backgrounds of RMC's professional staff reflect our experience in diverse fields such as population control and community health; health services administration and delivery; care of the elderly; family support and income maintenance; post-secondary education administration and delivery; and capital development for all sectors ranging from strategic/master planning to architecture. These backgrounds are complemented by the capabilities of our colleagues in the corporate planning, information systems, human resources, and productivity improvement parts of our practice. For more information on our work with health authorities and hospitals, please refer to the next section titled Our Work in Facility Planning.

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Health and Social Services

Members of RMC have been involved, both nationally and internationally, in health and social services projects as diverse as countrywide comprehensive health care restructuring; the establishment of regional health authorities; the development of management planning and control systems and specialty studies for individual institutions; and assisting clients to manage complex technical and capital works projects.

Typical Assignments

  • RMC was awarded a WB Health Workforce and Services project in Indonesia to assist the MOH, Ministry of National Education and Indonesia Medical Association and the provinces in their joint effort to improve their institutional capacity for human resources policy and planning in accordance with the current and future health care needs of the population (2002).

  • As part of the $134 million IDB funded Health Sector Reform Programme, RMC was retained by the MOH of Trinidad & Tobago to assist the Project Administration Unit in the selection of appropriate consultants, the evaluation of their work and the administration of their contracts involving some 100 technical assistance projects encompassing:

    • Reform of the Ministry of Health
    • Devolution of Service Delivery to RHA
    • PHC Development, Promotion & Training
    • Rationalizing of Health Service Delivery
    • Development of a Comprehensive Financing System and, in the process, transfer such knowledge, skills and systems to the MOH and RHAs.

Also acting as advisors to the Minister and senior Ministry officials on policy issues arising from the health care restructuring, as well as to undertake, on a sole-source basis, a number of the consultancies: the most significant over the recent past, include (1999-2005):

  • The development of a National Emergency Medical Services (NEMS) policy and operational framework for Trinidad & Tobago (T&T) including: situation analysis; medical direction; integration into hospital services; scope and funding; human resources/training; quality management; MIS; preventive maintenance; and community/public information. Also prepared a Tender Document to effect outsourcing of day-to-day management NEMS capable to provide advice and guidance to RHAs to operate a NEMS in their respective regions (2001-2002).
  • National Health Insurance. Provided advice to the MoH regarding health financing/cost recovery as a prelude to the introduction of a National Health Insurance scheme. Organized two seminars with internationally recognized experts as speakers, attended by major stakeholders (2002).
  • Pharmaceutical Services. Assessed the strength and weaknesses provided by the private and public sectors throughout T&T and provided advice and assistance in the design of chronic disease drug program for the population 65+ and the disabled including monitoring assistance during programme implementation (Phase I); Developed a National Pharmaceutical services plan including products to be available (public/private); National Drug Formulary (content and administration); procurement, storage and distribution; financial implications, projected budgets and funding options; policy, legislation, human resources, organization systems; implementation time-frame (Phase 2) (2002-2003).
  • National Needs Assessment (NNA). The overall objective of the project was to facilitate the development of NNA capacity in the MoH of T&T and in so doing to enable the RHAs to assess health care needs, prioritize the needs and interventions in the most efficient and effective manner. Also to train and build capacity within the RHAs to be able to carry out NNA in the future and to incorporate NNA as part of their annual regional health care plans (2003-2004).
  • Retained to provide financial management and procurement advisory services to the Albania Ministry of Health, PCU on a USD17 million W.B. funded Health Systems Recovery and Development Project to rationalize and strengthen the governance structure and management capacity at the national and regional levels and to improve the effectiveness and quality of health service delivery in the Tirana Region (1999-2001).

  • RMC was commissioned by the Alberta Provincial Health & Wellness Department to revise the 1995 Health Needs Assessment Guide so that it is "user friendly" and incorporates new information, approaches and language, e.g. Accountability Framework, Expectations and Measures; Health Authority Business Plan and Annual Requirements; Health Trends; RHA Health Needs Assessment Review and Expectations. RMC worked with a committee from seven of the RHAs and the Ministry. The revised guide incorporates key planning information from the RHAs, e.g. their successes, anecdotal information, etc., and reference material. (2001)

  • Guyana Health Sector Policy and Institutional Development Program funded by IADB. The 20 month project, with 63 person-months of professional level of effort dealt with health policy; legal and regulatory issues; health economics/financing; financial management/ MIS; health planning/epidemiology; public health/PHC; health services management; human resource development and management; hospital administration; quality assurance; health education and promotion. (1999-2000).

  • Secondment of a Senior Principal for a one-year period to be the Director of the Program Management Office (PMO) of a Smart Systems for Health project of the Ontario Ministry of Health. The objectives of the PMO was to design infrastructure to deliver Smart System products and services; establish standards and policy for the future use of technology; recommend governance, financing and security policies; coordinate efforts of health sector and technology partners; and raise health policy issues for determination by the Ministry of Health. About 80 professionals, including three from RMC, were involved during the course of the project.

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  • Development and execution of a three-day conference in Budapest, Hungary entitled Hospital Based Management Information Systems - The Canadian Experience under the auspices of the World Bank, the Canadian and Ontario Governments and attended by senior Ministry of Health officials from Central and Eastern Europe, the Baltic Republics and former Soviet states.

  • Conducted a needs assessment study that dealt with identifying continuing/long term care directions in the Lloydminster Health District (Saskatchewan). The study entailed: developing population and long term care bed forecasts; researched trends in long term care delivery; interviewed key stakeholders; conducted focus group with area residents; and developed program alternatives.

  • Retained by the WestView Regional Health Authority (Alberta) to conduct a regional health needs assessment. The study work plan included: an analysis of demographic and health status information; stakeholder and community input through the use of stake-holder work sessions, community focus groups and a telephone survey of 600 residents; the identification and validation of health needs.

  • RMC assisted the WestView Health Region to develop terms of reference for private partnerships in the design and operation of continuing care beds in the Hinton and Evansburg communities.

  • Review of continuing care programs for Palliser Health Authority (Alberta). The study included: review of current programs and services; key stakeholder consultation and site visits; focus groups with continuing care users and their family caregivers; research regarding program innovations in continuing care; a population and bed forecast projection for the region; and development of program options.

  • As part of a consortium retained by the Hungarian Ministry of Welfare, World Bank PMU on a Heart Healthy Nutrition Project, RMC's role was to provide assistance in project management, and health promotion.

  • Provided financial management and procurement advisory services to the Georgia MOH, PCU on a World Bank funded project dealing with health systems, human resources, health financing and rehabilitation of health facilities.

  • RMC, in partnership with Cambridge Consulting Corporation, provided to the Belize MOH and Sports, advisory services to the Health Policy Reform Project. The objective is to increase the ability of the MOH to identify, design, implement and evaluate strategies and policies to improve efficiency, equity and quality of the Belizean health care system.

  • During the 1990's RMC organized and conducted Fellowship Programs for Ministers of Health and their senior officials from Estonia, Georgia, Lithuania, Poland, Slovenia and Ukraine, introducing them to the Canadian experience in health care restructuring.

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  • Retained by the Armenia Ministry of Health to provide advisory services dealing with primary health care as a forerunner to a World Bank funded project.

  • RMC continues to work in health reform in Canada for Regional/District Health Authorities in Western Canada. Typical areas of involvement include determining health needs, trends and service requirements; identifying strategic options; recommending distribution of beds, service programs and location; evaluating the existing facilities, capacity for providing required services; and providing architectural block schematics for the purpose of planning and cost projections.

  • Assisted the Poland MOH in managing a US$135 million World Bank funded project (1994-1996). During 1992-93 RMC provided advisory services to the MOH in policy formulation and strategic planning and the development of a work program for the introduction of a national health insurance. On the WB assignment emphasis was on: health promotion, primary health care, health management training and education, pharmaceutical monitoring, MIS/IT, and physical evaluation of hospitals.

  • Assisted the Estonian Minister of Social Affairs in managing a W.B. funded health sector project, including assistance in accounting, administration and procurement; development of course material for training of local architects in the design of health architects in the design of health facilities; and physical planning and cost estimation of a new Biomedical and Health Sciences Complex.

  • RMC provided advisory services to the Lithuanian Minister of Health and senior Ministry officials in policy formulation; health legislation; primary health care; health financing/cost recovery; organizational issues; management development/manpower planning; and other advisory services necessary for the development of an effective health care delivery.

  • Retained by Turkey MOH, Health Reform Project, to review proposed universal health insurance scheme, resulting in recommendations to modify the process and content of the Project.

  • For the Slovenia Ministry of Health, RMC introduced Ministry officials to organization structures, management concepts and systems and procedures for health care delivery and assisted officials to identify those that would best serve Slovenian needs.

  • Assisted the Uganda Ministry of Health to prepare for the Second World Bank Health Project. In addition to studies in institutional strengthening, decentralization, information systems and NGO/private-sector AIDS programming, RMC also completed a detailed feasibility study of relocating the Ministry of Health Headquarters from Entebbe to Kampala.

  • RMC assessed the health care sector and type and nature of health care delivery in Belarus and Ukraine as part of the World Bank team.

  • In the Bahamas, RMC was involved in restructuring and institutional strengthening of the MOH. The work included policy formulation, planning and programming; formulation of health legislation; organization and managerial reforms; design and implementation of cost accounting and management information system; development and implementation of a supply management system and maintenance program.

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  • Reviewed emergency services in 10 hospitals for the B.C. Ministry of Health, addressing such issues as categories and functions; referrals and regional and district control; ambulance diversion and the availability of emergency and ICU beds in comparison to the anticipated level of requirement; and underlying problems and factors contributing to the present status.

  • For the Mental Health Services Branch of the Saskatchewan Government, RMC completed a strategic study of long-term psychiatric care including development of values, principles and delivery system functions for guiding future planning. A key issue was the future of one remaining long-term psychiatric care hospital in the province and the viability of deinstitutionalizing its residents by providing their care from a community base rather than from a single centralized provincial facility.

  • Studied strategic options for Environmental Health in Alberta to establish a framework for organizing environmental health programming among government departments and local health units. Reviewed health promotion methods, risk determination methods and epidemiological data to establish an agenda of health issues requiring priority attention by the government. The study developed definition of and responsibilities in environmental health for Alberta Health and its local health units.

  • Directed and jointly conducted a review of cancer services in Ontario with Coopers & Lybrand. The study examined respective mandates of Ontario Cancer Treatment and Research Foundation and Ontario Cancer Institute; examined and evaluated alternative options for their organizations; recommended changes i.e., programs, manpower, equipment and space; addressed cost implications; and proposed merging 2 organizations into a single provincial agency, resulting in a $200 million funding program by the government of Ontario.

  • On behalf of Canadian International Develop-ment Agency, completed a multi-year family planning project in Bangladesh. Project included monitoring and improving procurement and distribution of 18million cycles of oral contraceptives; researched acceptance and effects.

  • Conducted an organization study of the 452-bed Dr. Everett Chalmers Hospital in Fredericton, New Brunswick; a similar study was also conducted for the 207-bed Glenrose Rehabilitation Hospital in Edmonton, Alberta.

  • On behalf of Alberta Social Service and Community Health, RMC reviewed the Coordinated Home Care Program in Alberta and evaluated its performance after 4 years of operations.

  • On behalf of Health and Welfare Canada, studied present and potential alcohol/drug problems in Northwest Territories and developed a strategic plan to provide effective, community-based prevention and treatment services.

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  • On behalf of the government of Newfoundland, conducted a study of health care delivery in the Central Region; including a major review of 10 hospitals and development of strategic plan defining their new role. Undertook a similar study for Inuvik Region of NWT.

  • Assessed health facility requirements in 2 health delivery sectors for Metro-Edmonton District 106 and examined options to meet perceived needs. Study team visited model health service and health maintenance organizations in Ontario and the United States.

  • On behalf of the government of Alberta, con-ducted a feasibility study to establish the scope, anticipated costs and implications of developing a computer-based planning model capability to facilitate predesign planning of health care facilities, including needs analysis, definition of project scope and functional planning.

  • Completed a comprehensive study of health care delivery in the Yukon Territory for Health and Welfare Canada. Study included needs assessment, operating system, planning requirements, and financial implications; also a master development plan for the Whitehorse General Hospital.

  • RMC worked on a number of assignments over a 3-year period on behalf of the Alberta Children's Provincial Hospital (ACPH) and the Foothills Provincial General Hospital, including an examination of patient care, diagnostic services, human resources and medical/nursing education.

  • For the Alberta Workers' Compensation Board Rehabilitation Centre, RMC completed operational review and a strategic management plan including development of mandate and objectives in area of rehabilitation, including service delivery model and implementation strategy.

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  • Conducted study for Corrections Canada to determine the requirements for a Regional Health Centre to serve the needs of all Pacific Region (B.C.) correctional institutions and its potential viability with the Regional Psychiatric Centre.

  • RMC offered advisory and executive search services to the University of Colorado to staff King Khalid Hospital, an 800-bed acute care facility, in Riyadh, Saudi Arabia.

  • Developed strategic plan for delivery of geriatric and rehabilitation services for residents of Yukon Territory.

  • On behalf of the N.W.T. Registered Nurses Association, RMC assessed future role of nursing within context of changes in the Canadian health care system and emerging issues in health care services for women in the Northwest Territories.

  • Formulated a policy on palliative care for Alberta Hospitals and Medical Care, to serve as planning framework for the establishment of programs throughout Alberta.

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    Education

    Universities and community colleges, which are called upon to develop programs and capital facilities that will respond to community and regional needs, are faced with competing and conflicting demands. RMC, with a multi-disciplinary staff and experience in planning post-secondary institutions, undertaking feasibility studies and organization and operations reviews, is well-suited to assist agencies responsible for providing education.

    Typical Assignments

  • Southern Alberta Institute of Technology (SAIT) Aero Centre Functional Program for the proposed development of a new SAIT Aero Centre for Training and Technology. The purpose of the functional program was to identify the programmatic and spatial requirements of the Aero Centre for Training and Technology. (2002)

  • Keyano College, MacKenzie Campus Development Study (2002) to address both short term priorities and longer term requirements. The study assessed existing and potential utilization, examined limitations of existing facilities and infrastructure and opportunities to enhance viability of the campus, identified options for facility use and development and recommended capital developments to accommodate the proposed changes. Other projects for Keyano College included: Technology Centre Functional Prograrmme (2001), and; Sports and Wellness Centre, Programme Concept (2002).

  • University of Alberta, National Research Council of Canada, National Institute for NanoTechnology (NINT), Detailed Space Programme (2002). RMC identified the programmatic, functional and space requirements for the proposed NINT facility, as a basis for the architectural and engineering design of the building. (2002)

  • University of Alberta and National Research Council, National Institute for Nanotechnology, Functional Programme. The space programme identified the programme and space requirements and related functional and technical criteria to accommodate the NRC both for the interim period and plan the space for long term use by UofA. The space programme provided the basis for the architectural and engineering design of the facility. (2001)

  • University of Alberta, National Resources Engineering Facility (NREF), Detailed Space programme. RMC, in partnership with The Cohos Evamy Partners, prepared the detailed space programme for the Department of Civil and Environmental Engineering. RMC identified the programme and space requirements for a new building for the NREF to accommodate the research, instructional and administrative functions of the Department. Documentation was prepared in accordance with U of A standards to provide the information necessary for the subsequent stages of design (2001).

  • For Grant MacEwan Community College in Edmonton, Alberta, provided strategic planning services including identifying intermediate and long-term facility needs to support the changing client base and the new delivery systems required in the market area, also examined consequences arising from various development options.

  • For the Alberta College in Edmonton reviewed all business education programs with emphasis on training using new technologies, including development of future directions relevant to employment opportunities and the needs of the business community.

  • Alberta Advanced Education & Career Development anticipates that some 25,000 new additional students will have to be accommodated by the year 2005. RMC was commissioned to determine the accommodation capability (capacity) of the existing post-secondary educational facilities. The study determined that the most valid and consistent indicator of capacity is classroom space availability and utilization. Using several utilization factors, the study arrived at accommodation capability in the range or 109,000 to 128,000, with the lower end being close to the existing enrolment in the system and the higher range capable of handling the expected enrollment to the year 2005.

  • Conducted a strategic study for Northern Alberta Development Council on adult education and training needs. The study examined the existing system and its delivery capability; future needs; and models required to deliver the required services within the context of major hydrocarbon and forestry developments in Northern Alberta.

  • Prepared a strategic plan for Thebacha College in Fort Smith, Northwest Territories, with satellite facilities in 5 other NWT communities. This became a study of post-secondary education throughout the territories including the review of the educational programs and operations; an assessment of needs generated by normal growth and hydrocarbon-industry-induced growth in context of socio-economic factors; facility evaluation; and identification of issues and service gaps.

  • Provided advisory services in campus development to the University of Calgary in preparation of detailed functional programs for 3 major capital projects connected with the 1988 Winter Olympics.

  • For the Alberta Ethnic Language Teachers' Association, RMC conducted a feasibility study and prepared a strategic plan for multilingual centres. The study assessed the need for multilingual centres in Edmonton and Calgary, determined commitment of existing heritage schools to a new multi-lingual centre, determined availability of suitable facilities, designed an administrative structure, and developed pro forma operating budgets.

  • For the Lakeland College, completed 5 separate projects that included: a long-range plan and Strategy for Growth; operational budget reviews; functional programming of a major building renovation; detailed energy conservation analysis of the entire Vermilion campus; and planning and programming for the new $40 million campus for 850 students in Lloydminster, Alberta.

  • Developed system of rating degree of urgency of proposed capital and maintenance projects. The system was customized to requirements of the University of Alberta and includes a number of factors ranging from health and safety concerns to anticipated program changes. It is being used to rate projects of all sizes and produces an objective prioritized list which can be used to justify funding requests.

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